GA Telesis Revision: 3

Supplier Evaluation Audit Form Revision Date: 3/30/2017

Page: 1 of 4
F100-02

SUPPLIER EVALUATION AUDIT

GA Telesis is required to use approved Suppliers and Repair Stations. As a potential Supplier, you are
requested to provide quality evidence of your facility and procedures. Please complete this survey and
provide all requested documentation.

Date: Company Name:

Address:

City: State: Zip Code:

Telephone number: E-Mail:

Company Website if available:

Organization Head: Title:

Quality Control Manager:

Who does the Quality Control Manager Report to?

Type of Business:
☐Manufacture (OEM) ☐Surplus Parts Dealer
☐Manufacture Maintenance Facility (MMF) ☐Distributor
☐Repair Station ☐Broker
☐Air Carrier ☐Other
☐Military Distributor Only Describe:
Brief description or articles/services provided:

F100-02 Rev. #3
GA Telesis LLC
Confidential: PROPRIETARY INFORMATION, NOT FOR DISCLOSURE UNDER ANY ACCESS TO INFORMATION OR SIMILAR
LAWS OR OTHERWISE WITHOUT THE PRIOR WRITTEN CONSENT OF GA TELESIS, LLC.
 GA Telesis Revision: 3
Supplier Evaluation Audit Form Revision Date: 3/30/2017
Page: 2 of 4
F100-02

QUALITY CONTROL SYSTEM

1. Are you accredited to any of the following? (Please check all that apply)
☐ASA-100 ☐AS9100/AS9110/AS9120
☐TAC-2000 ☐FAA
☐ISO-9001 ☐EASA
☐CAAC ☐Other

If accredited to any of the above, please send copies of applicable certifications along with this survey. You
may skip questions 2 -20 and complete the signature section. FAA Repair Stations send capability list & provide
proof of Anti-Drug & Alcohol Program.
If you are not accredited to any of the above, please complete the entire survey and provide a copy of your
quality manual.

2. Do you have an established Quality System and a Quality Manual kept current and
readily available to employees, customers, auditors or designee(s)?
☐Y ☐N ☐N/A
RECEIVING PROCEDURES
3. Does the supplier have an established system of receiving Inspection and do the receiving records indicated
acceptance or rejection of material?
☐Y ☐N ☐N/A
4. Does the supplier obtain certification on material received as applicable to requirements and maintain
traceability as it pertains to the material?
☐Y ☐N ☐N/A
DOCUMENTATION
5. Are the records and documentation received as originals properly completed and signed?
☐Y ☐N ☐N/A
6. Do life-limited parts have full traceability with verification of time remaining?
☐Y ☐N ☐N/A
7. Do you provide an 8130-3/EASA FORM 1 or TCCA Form one Maintenance Release documents with parts as
required by regulatory standards?
☐Y ☐N ☐N/A
8. Can you supply an ATA specification 106 Material certification with the parts you provide?
☐Y ☐N ☐N/A
9. Do you verify that parts were not removed from an aircraft/engine that was subjected to extreme stress or
heat; or that the parts were not obtained from any government or military source?
☐Y ☐N ☐N/A
10. Do you keep the Records and documentation for 7 Years?
☐Y ☐N ☐N/A

F100-02 Rev. #3
GA Telesis LLC
Confidential: PROPRIETARY INFORMATION, NOT FOR DISCLOSURE UNDER ANY ACCESS TO INFORMATION OR SIMILAR
LAWS OR OTHERWISE WITHOUT THE PRIOR WRITTEN CONSENT OF GA TELESIS, LLC.
 GA Telesis Revision: 3
Supplier Evaluation Audit Form Revision Date: 3/30/2017
Page: 3 of 4
F100-02

MATERIAL STORAGE
11. Does the supplier have adequate space to preclude damage to parts and does the supplier properly
tag/Identify all parts?

☐Y ☐N ☐N/A

12. Is there a system to segregate and identify serviceable from unserviceable and aviation from non-aviation
material?

☐Y ☐N ☐N/A

13. Do you mutilate scrapped articles to the extent that will preclude the possibility of them being restored
and returned to service? (Reference AC21-38/FAA ORDER 8120.11)

☐Y ☐N ☐N/A

14. Do you have an ESD work station in place?

☐Y ☐N ☐N/A

15. Do you have a shelf life program in place?

☐Y ☐N ☐N/A
SHIPPING/PACKING
16. Does the supplier verify parts against paperwork prior to the parts shipping out?
☐Y ☐N ☐N/A
17. Are adequate controls in place to insure proper packaging of material in accordance with ATA
specification 300 or equivalent?
☐Y ☐N ☐N/A
TRAINING & PERSONNEL
18. Do you have a training program in place and do you keep records of all trained personnel?
☐Y ☐N ☐N/A
19. Do you maintain a training roster of the personnel and their
alternates authorized to perform inspections and other company functions they are able to perform?
☐Y ☐N ☐N/A
20. Is the Quality manual available for our review?
☐Y ☐N ☐N/A
21. Do you have a process to ensure all sub-contracted maintenance/preventative maintenance providers, at
all tiers (certified and non-certified) have an FAA approved and active anti-drug and alcohol prevention
program?
☐Y ☐N ☐N/A
Do you have an FAA approved and active anti-drug and alcohol program in line with 49 Code of Federal
Regulations (CFR) part 40 and 14 CFR Part 120?
☐Y ☐N ☐N/A

F100-02 Rev. #3
GA Telesis LLC
Confidential: PROPRIETARY INFORMATION, NOT FOR DISCLOSURE UNDER ANY ACCESS TO INFORMATION OR SIMILAR
LAWS OR OTHERWISE WITHOUT THE PRIOR WRITTEN CONSENT OF GA TELESIS, LLC.
 GA Telesis Revision: 3
Supplier Evaluation Audit Form Revision Date: 3/30/2017
Page: 4 of 4
F100-02

SIGNATURE

The results of this survey will be verified by GA Telesis Quality Department,

Along with this survey, please include the following documentation:

1) Copies of your accreditation certificates, minority business certification or any other approvals you may
have.
2) Letters of approval from major customers (if available).
3) Copy of your Quality Manual if not approved under any standards in step #1

Please forward this signed, completed survey along with certifications to your contact at GA Telesis.

Note: If certifications are revoked or suspended the supplier or vendor shall notify GA Telesis immediately
upon suspension.

Person Completing Form

Name: Date:

Email: Phone Number:

Title:

F100-02 Rev. #3
GA Telesis LLC
Confidential: PROPRIETARY INFORMATION, NOT FOR DISCLOSURE UNDER ANY ACCESS TO INFORMATION OR SIMILAR
LAWS OR OTHERWISE WITHOUT THE PRIOR WRITTEN CONSENT OF GA TELESIS, LLC.